The Tattoo Removal Guide
FracTAT, Explained: How Pink Accelerates Tattoo Removal
FracTAT ® is a combined fractional pre-treatment and Q-Switched laser protocol that allows multiple effective passes in a single removal session, by giving the gas generated during treatment a route to escape. Here is the mechanism, the published clinical evidence, what the evidence says and does not say, and how Pink assesses candidacy.
Standard Q-Switched laser tattoo removal delivers one effective pass per session. The reason is a physical limitation: when the laser energy reaches the ink, it generates gas that rises to the skin surface as a white frost layer. That frost blocks the laser’s path to the deeper ink below. Treating again immediately would mean firing through a cloudy barrier. So the clinician waits, typically fifteen to twenty minutes, for the frost to clear before passing again.
One limitation of that architecture is that it usually means one clinically effective pass per session.
FracTAT ® changes this. By solving the gas problem before it forms, FracTAT allows multiple effective laser passes in a single session. This article explains how, what the evidence for the outcome shows, and when FracTAT is and is not the right protocol.
What FracTAT is: the two-step mechanism
FracTAT is a combined fractional procedure followed by Q-Switched laser treatment, delivered in a single session.
Step one: the fractional pre-treatment. Before the Q-Switched laser passes begin, a fractional handpiece creates a precise array of microscopic channels in the dermis at the tattoo site. These channels, micro-columns of treated tissue, act as pressure-relief ducts for the gas that the Q-Switched laser-ink reaction will generate.
Step two: the Q-Switched laser passes. The StarWalker MaQX then delivers Q-Switched and MaQX hybrid passes through the same area. The gas generated by the laser-ink reaction, the same gas that would normally form the optical-blocking frost layer, escapes through the pre-drilled channels rather than accumulating at the surface. With the frost pathway neutralised, multiple effective passes can be delivered in a single session.
The mechanism is Fotona’s published documentation for the FracTAT protocol, and Pink’s implementation of it is direct: the micro-channel creation and the Q-Switched passes are delivered in the same appointment, using Pink’s two-platform configuration.
Pink’s two FracTAT pathways
Pink runs two Fotona platforms in tandem for tattoo removal: the StarWalker MaQX and the SP Dynamis. This configuration makes both FracTAT pathways available, which is unusual.
The FS20 Nd:YAG photoacoustic fractional pathway (StarWalker MaQX): The FS20 handpiece on the StarWalker MaQX uses photoacoustic energy to create the micro-channels. This is the pathway used in the only published peer-reviewed clinical series of the FracTAT method (Marini et al., 2021, see the evidence section below).
The FS01 Er:YAG ablative fractional pathway (SP Dynamis): The FS01 handpiece on the SP Dynamis uses true ablative Er:YAG energy at 2940 nm to drill the micro-channels. This is the original FracTAT pathway described in Fotona’s technical documentation, and it is evidenced in a split-lesion study (Sardana et al., 2015) showing 1.6 versus 3.8 sessions for the FracTAT-treated versus standard-treated halves of the same lesion. Both pathways are available at Pink; the clinical choice between them is made at the session based on the tattoo and the skin.
The published evidence: what it shows and what it does not
The question most clients considering FracTAT want answered is: does it actually reduce the number of sessions, and by how much?
The published peer-reviewed evidence comes from a single clinical series. Marini, Marini, Cutlan, and Hreljac (2021) treated ten patients with thirteen professional tattoos using the FracTAT method (FS20 Nd:YAG photoacoustic pathway). The findings:
- Average pigment clearance: 97%
- Median sessions to that clearance: 4.85
- Session reduction versus the Kirby-Desai scale predictions: approximately 40% fewer sessions
The Kirby-Desai scale is the clinical tool used to estimate expected session count for Q-Switched tattoo removal. The 40% reduction figure is a comparison against what the Kirby-Desai scale would have predicted for the same tattoos treated with a standard single-pass approach. It is not a controlled head-to-head trial against an untreated or standard-treatment control arm.
These are the study’s findings. These are also the study’s limitations, which the same passage must carry:
The cohort is ten patients with thirteen tattoos. All participants were Fitzpatrick type II. The majority of tattoos were monochromatic black. No larger randomised trials of the FracTAT method have been published. The lead author has declared Fotona honoraria. The 40% figure is a comparison against modelled predictions, not a controlled experimental result.
This is the published evidence base for the protocol Pink runs. It is meaningful, 97% average clearance at a median of under five sessions is a clinically significant finding. And it is small, and it is specific to the population it studied. Pink does not represent the Marini findings as a per-client expectation.
Who FracTAT is for
FracTAT is a choice, not a default. Pink assesses candidacy at consultation based on specific clinical factors.
Candidates who are likely to benefit from FracTAT:
Clients for whom total time to clearance is a high priority. FracTAT’s primary clinical argument is session reduction. If the gap between eight sessions over eighteen months and five sessions over ten months is meaningful to the client, for career, life event, or other reasons, FracTAT’s session-reduction profile is directly relevant.
Clients with prior limited progress. Where a standard Q-Switched approach has produced slower-than-predicted progress over multiple sessions, the multi-pass-per-session architecture of FracTAT may address the plateau. This is worth raising at consultation rather than committing to more single-pass sessions first.
Clients with some specific textural concerns around the tattoo area. The fractional pre-treatment creates micro-channels that can, in some cases, address mild textural concerns in the treated skin as a secondary effect. This is not a primary indication for FracTAT and should not be represented as a guaranteed skin benefit.
Suitable tattoo and skin profile. The consultation assesses whether the specific tattoo and skin are appropriate for FracTAT. Not every tattoo is a good FracTAT candidate; the clinical team’s assessment at consultation determines suitability.
Candidates for whom FracTAT may not be indicated:
Clients who have not yet established a baseline response with standard Q-Switched sessions are often better served by starting with a standard approach and assessing FracTAT if progress is slower than expected. FracTAT is not indicated as the first protocol for every client.
FracTAT for eyebrow tattoo removal
FracTAT is available at Pink for suitable candidates undergoing eyebrow tattoo removal, as well as body work. The protocol is assessed on the same candidacy logic: total session reduction as a priority, suitable tattoo and skin, consultation assessment before proceeding.
For the full eyebrow removal picture, see Eyebrow tattoo and microblading removal, explained.
Is FracTAT available at every clinic?
Pink can speak to its own capability, not to other clinics’. What Pink can say: the FracTAT protocol requires two Fotona platforms in the same clinic, the StarWalker MaQX for the FS20 Nd:YAG photoacoustic pathway and the SP Dynamis for the FS01 Er:YAG ablative pathway. Both of these require specific Fotona handpieces that are not available on non-Fotona systems. Pink runs both platforms and both handpieces.
What FracTAT feels like and what recovery is like
FracTAT involves an additional treatment step, the fractional pre-treatment before the Q-Switched passes, which adds both time and a sensation component to the session. The pre-treatment step is generally described as an additional layer of discomfort on top of the standard removal sensation: not dramatically more intense per pulse, but an additional element in the experience.
Comfort management protocol is the same: cooling throughout, topical anaesthetic available if preferred. Most FracTAT clients find the combined session manageable.
The published international evidence on FracTAT recovery describes most patients tolerating the procedure well, with minimal downtime and a return to normal activities typically the next day or immediately. Some individual accounts describe more intense post-session sensitivity than with standard removal. Pink’s protocol for post-FracTAT care is the same as for standard removal, with the same guidance on the first ten days.
For the full sensation picture, see What tattoo removal actually feels like. For the full aftercare picture, see Tattoo removal aftercare: the first ten days.
The cost structure
The per-session cost for FracTAT is higher than standard removal, because FracTAT involves both platforms and a longer session. The argument for FracTAT is that the per-session premium is offset by the reduction in total sessions. Whether that produces a better or worse total program cost depends on the specific plan, which the consultation establishes.
For the full cost picture, see How much does tattoo removal cost in Melbourne?. Exact pricing is on Pink’s tattoo removal page.
Book a free consultation at Pink’s Doncaster clinic. FracTAT candidacy is assessed at consultation, where the clinical team can read the tattoo, the skin, and the treatment goal and give you a specific recommendation.
Frequently Asked Questions
What is FracTAT and how is it different from standard laser tattoo removal?
Standard Q-Switched laser removal typically delivers one effective pass per session. FracTAT adds a fractional pre-treatment step that creates microscopic channels in the dermis, acting as pressure-relief ducts for the gas the laser-ink reaction generates. With that gas escaping through the channels instead of accumulating as an optical-blocking frost layer, multiple effective laser passes can be delivered in a single session. The result is more ink fragmentation per session, with the session-reduction profile the published evidence documents.
Does FracTAT really reduce the number of sessions needed, and what does the evidence actually show?
The published peer-reviewed evidence for FracTAT comes from a single clinical series: ten patients with thirteen professional tattoos achieved approximately 97% pigment clearance at a median of 4.85 sessions, approximately 40% fewer than the Kirby-Desai scale would have predicted for standard single-pass treatment. The series is small (all Fitzpatrick type II, mostly monochromatic black), no larger randomised trials have been published, and the 40% figure is a comparison against modelled predictions, not a controlled trial result. The lead author declared Fotona honoraria. This is the evidence base; it is meaningful and it is limited. Pink does not present the Marini findings as a per-client expectation.
Is FracTAT suitable for all skin types, including darker skin?
FracTAT is assessed for suitability at consultation, which includes the skin type consideration. Pink’s standard Q-Switched platform is FDA-cleared for tattoo removal across all Fitzpatrick types at 1064 nm in PICO mode. FracTAT uses the same 1064 nm foundation. The published Marini series was conducted on Fitzpatrick type II patients only, so the evidence base for FracTAT’s session-reduction profile on darker skin types is not as established. The clinical safety profile of the underlying 1064 nm Q-Switched platform on darker skin types is documented in the broader literature (Kirby et al., 2016, 1,041 patients, zero keloids, zero scarring among 38 FST V–VI patients). FracTAT candidacy on darker skin types is a consultation assessment.
Can FracTAT be used for eyebrow tattoo removal, not just body tattoos?
Yes. FracTAT is available at Pink for eyebrow tattoo removal for suitable candidates. The candidacy assessment includes the pigment type, the skin type, and whether a test patch has been done. FracTAT for eyebrow work is a choice, not a default. See Eyebrow tattoo and microblading removal, explained for the eyebrow context.
What are the two pathways within FracTAT?
Pink runs two FracTAT pathways. The FS20 Nd:YAG photoacoustic fractional pathway uses the FS20 handpiece on the StarWalker MaQX: this is the pathway used in the Marini 2021 clinical series. The FS01 Er:YAG ablative fractional pathway uses the FS01 handpiece on the SP Dynamis, creating true ablative micro-channels; this is the original FracTAT pathway evidenced in Sardana et al. (2015). Both pathways are available at Pink; the clinical choice between them is made at the session based on the tattoo and skin. Most tattoo removal clinics do not have both platforms.
Does FracTAT hurt more than standard removal, and what is the recovery like?
FracTAT involves an additional fractional pre-treatment step that adds a sensation component. It is generally described as an additional layer of discomfort rather than dramatically more intense per pulse. Cooling management and topical anaesthetic are available as for standard removal. Recovery follows the same first-ten-days protocol. Published international evidence describes most patients tolerating FracTAT with minimal downtime. See What tattoo removal actually feels like and Tattoo removal aftercare: the first ten days for the detailed pictures.
Is FracTAT available everywhere or only at specific clinics?
FracTAT requires specific Fotona platforms and handpieces. The FS20 Nd:YAG photoacoustic pathway requires the StarWalker MaQX with the FS20 handpiece; the FS01 Er:YAG ablative pathway requires the SP Dynamis with the FS01 handpiece. Pink runs both and offers both pathways. Clinics that do not run Fotona systems or do not have both handpieces cannot deliver the full FracTAT protocol.
Book Your Free Consultation
FracTAT candidacy is a consultation decision, not a website one. Pink’s consultations are free and include a clinical read of the tattoo, the skin, and whether FracTAT is the right protocol for your specific situation.
Book your free consultation (opens in a new tab).
For the full treatment picture, see Pink’s tattoo removal page. For the session-count picture, see How many sessions does tattoo removal really take?.
